大肠癌病人的多原发恶性肿瘤临床分析

Multiple Primary Malignant Neoplasms in Patients with Col n(?)c Carcinoma : A Clinical Analysis of 31 Cases

多原发恶性肿瘤以大肠癌病人较为常见。其发生率有逐渐上升的趋势。本组31例中,同时多原发大肠癌16例,异时多原发大肠癌6例,大肠癌患者患其他部位恶性肿瘤9例。异时多原发大肠癌可发生在首发癌8月～23年后,因此对大肠癌病人必须终身跟踪和监测。异时多原发大肠癌三次手术以上者可考虑作全结肠或全大肠切除。积极处理癌前期病变——大肠息肉,可减少大肠癌和多原发大肠癌的发生。

Twenty one patients with multiple primary maligrant neoplasms of large intestine (account for 9.3% of all colonic carcinomas of the coresponding period) were treated in our hospital from Jan. 1985 to Dec. 1990. 1 of them suffered from the multiple primary colonic carcinonas synchronously,6 of them suffered from the asynchronous, and the rest hai both colonic carcinomas and extracolonic primary malignant tumors simultaneously. The diagnoses of the multicentric colonic carcinomas should be done by three ways-examinations of large intestine before operations, careful exploraions in operations, and opening the specimens after operations. The synchronous carcinomas at same or adjacent place of colon should be expanded the ranges of the operations. Ones of the different places of colon shonld be performed by radical operations of two parts. Asynchronous colonic carcinomas may be discovered from 8 months to 23 years after the first operations. So the patienis of colonic carcinomas should be followed up and examined for their lives. It is incorrect to regard the asynchronous colonic carcinomas and the extracolonic primary malignant tumors as metastases or recurrences.